Looking for health insurance for me and my wife, and employer option seems way too outrageously priced

As the title says, my wife and I (28 and 29, healthy) need medical insurance. My wife’s job doesn’t offer any, and the insurance from my job seems ridiculously expensive. The basic plan is $650/month (pre-tax, I think) for both of us, with a $3,000 individual deductible before the insurance starts covering anything.

The “buy-up” plan is better, with most visits only needing a copay, but it only covers 80% for ER and urgent care (until you hit the max out-of-pocket). That one costs $800/month.

I might be spoiled because, for 3.5 years, I worked a union job in Florida and only paid around $250/month for great coverage for both of us. Am I out of touch for thinking paying almost as much as rent for insurance is ridiculous? Are there better options in my state?

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It looks like your previous job had significantly better benefits. Paying $650 for employee and spouse coverage isn’t unusual; it really depends on how much your employer contributes. Paying only $250 per month for both is an incredible deal! A $3,000 deductible is higher than the average for most employer plans, but with a High Deductible Health Plan (HDHP)—which it seems like you have since you mentioned needing to hit the deductible first—that’s expected because HDHPs have a minimum deductible to qualify for an HSA. The main benefit of an HDHP is gaining access to that HSA.

If the cheapest plan your employer offers costs no more than 8.39% of your income for 2024 (9.02% for 2025), it’s considered “affordable.” This might apply only to the employee-only plan, meaning your spouse could potentially qualify for a subsidy through healthcare.gov if the spouse plan is unaffordable. If your plan is considered affordable for both you and your spouse, you can still go with a marketplace plan, but you won’t qualify for a subsidy if your employer’s plan meets the affordability threshold.

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I completely agree that the benefits were much better at the old job, but the pay was dismal—starting at $14.25 an hour and barely reaching over $16 when I left. Now, I’m making $11 an hour more! It really feels like a monkey’s paw situation.

Together, my wife and I make about $6,000 a month (I earn $4,600, and she makes roughly $1,400). With my base plan costing $100 and hers at $550, it’s clear that her plan isn’t affordable based on her income.

It looks like the pricier plan is the only one worth considering, but I might need to explore the HSA option more. Having to pay out of pocket for everything until I hit that $3,000 deductible before insurance kicks in seems completely unreasonable.

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I understand—great benefits but lower pay. What do you do?

I will say that preventive care is still covered 100% under the HSA plan, just like the upgraded version. So, annual physicals and well-woman exams—assuming they’re truly preventive and not addressing any symptoms—will still be free. However, a PCP visit that isn’t an annual preventive check-up will be billed at the contracted rate, which means you’ll get a network discount rather than a copay. That could lead to costs around $125 for a visit.

Also, with your household income, the spouse rate isn’t affordable, so she could qualify for a plan through healthcare.gov. The subsidy would be based on your household income.

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The main reason I want insurance is for my wife’s benefit. Without getting into details, she needs access to psychiatric care and likely some medications. I can only imagine how expensive those medications would be if we had to pay for them entirely out of pocket.

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$650 per month is not too bad what is the OOP maximum for that plan?

For the $800 per month plan, what is the OOP maximum?

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6750 and 6050 respectively

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In-network and medically necessary, here’s the breakdown:

First Plan: $7,800 annual premium + $6,750 out-of-pocket maximum = $14,550 total possible annual cost
Second Plan: $9,600 annual premium + $6,050 out-of-pocket maximum = $15,650 total possible annual cost
If these figures represent family costs, the first plan is the better choice. You mentioned a $3,000 deductible—was that for an individual or a family? It’s a good idea to save up that deductible amount just in case.

Is your employer not offering a high deductible health plan (HDHP) with an HSA? Typically, these plans have much lower premiums, but the deductibles tend to be quite high.

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Sorry, I forgot to mention that those were the individual out-of-pocket costs. You should multiply by two for the family out-of-pocket maximum.

The deductible is $3,300 with the base plan and $2,500 with the buy-up (again, that’s per individual; so double it for family costs).

The base plan does offer an HSA, with the employer matching up to $40 per paycheck (or $80 a month), but the buy-up plan doesn’t include that benefit.

My main concern is that I would have to cover all expenses until we reach the deductible. Since my wife will likely need to see a specialist monthly and will probably have medication costs, it’s hard to justify spending even $400 a month. Considering pre-tax benefits, the employer HSA match, and other factors, just one specialist visit could run around $200, and her medication could be as much as $700 a month based on her previous prescriptions.

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Your old job offered a lower hourly wage but provided better health insurance coverage for you and your family. When evaluating job benefits, it’s important to factor in health insurance costs. You might still be better off with your new job, but in the future, be sure to consider all benefits associated with a position.